Organization
INTEGRATED PHYSICAL THERAPY AND SPORTS MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TATE C VAN HOUTEN DPT (OWNER/PHYSICAL THERAPIST)
(515) 288-0569
Entity
Organization
Contact information
Practice address
1515 LINDEN ST, SUITE 100, DES MOINES, IA 50309-3120
(515) 288-0569
(515) 288-0347
Mailing address
2213 GRAND AVE, DES MOINES, IA 50312-5305
(515) 237-3974
(515) 883-2692
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IN PROCESS
—
IA
Enumeration date
09/06/2012
Last updated
11/06/2012
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